Spinal Fusion
Spinal fusion is a surgical procedure which involves connecting two or more vertebrae in your spine permanently to eliminate motion between them. It involves techniques that can mimic the normal healing process of any broken bones. The procedure is performed to fuse together two or more vertebrae so that they may heal into a single, solid bone. This can help in eliminating painful motion as well as restoring stability to your spine.
This surgery is recommended only when your doctor is able to pinpoint the source of your pain. This procedure can help relieve symptoms of many back problems, such as degenerative disk disease, fractured vertebra, spinal stenosis, herniated disk, tumor, etc.
Purpose
Spinal fusion can permanently connect two or more vertebrae in your spine for improving stability, correcting a deformity as well as for reducing pain. Your doctor might recommend spinal fusion to treat any of the following:
Deformities of the spine- Spinal fusion helps in correcting spinal deformities, such as a sideways curvature of the spine termed as scoliosis.
Herniated disk- Spinal fusion can also be used for stabilizing the spine after removal of a damaged (herniated) disk.
Spinal weakness or instability- If there is excessive or abnormal motion between two vertebrae, this can lead to your spine becoming unstable. This is usually a common side effect of severe arthritis in the spine. Spinal fusion can be used for restoring spinal stability in such cases.
Preparation
Prior to your surgery, the surgical site will need to be cleaned with antiseptic and any hair will need to be trimmed. The surgical team can also order a swab sample to monitor any unhealthy bacteria in your nose. If you are taking any kind of medication, you need to let your doctor know. Before your surgery, you might need to stop taking them.
During the Procedure
You will be under general anesthesia during the procedure. There are a variety of techniques for performing this procedure. The technique which your surgeon uses can depend on the location of the vertebrae to be fused, the reason for your fusion as well as your body shape and overall health.
The procedure generally involves the following steps:
Incision
To gain access to the vertebrae being fused, your surgeon will first be making an incision in one of three locations, viz. in your neck or back directly over your spine, on either side of your spine, in your abdomen or throat. This will allow your surgeon to access the spine from the front.
Bone graft preparation
The bone grafts that will actually fuse the two vertebrae can come from a bone bank or from your own body, usually from your pelvis. If your own bone is being used, the surgeon will make an incision above your pelvic bone; then he/she will remove a small portion of it after which he will be closing the incision.
Fusion
For fusing the vertebrae together permanently, the surgeon will need to place the bone graft material between the vertebrae. He/she can use metal plates, screws or rods to help hold the vertebrae together while the bone graft heals.
There are surgeons who use a synthetic substance instead of bone grafts in selected cases. These synthetic substances can help to promote bone growth as well as speed the fusion of the vertebrae.
After spinal fusion
Usually after spinal fusion, you might need to stay in the hospital for two or three days. You may also experience some pain and discomfort, though it can be controlled with the help of medications.
After you reach home, remember to inform your doctor if you exhibit any signs of infections, such as:
- Redness, tenderness, or swelling
- Shaking chills
- Wound drainage
- Fever higher than 100.4 F (38 C)
It will take several months for your bones to heal and fuse together. You might also be recommended to wear a brace for some time to keep your spine aligned correctly. Physical therapy can guide you on how to sit, stand, and walk in a manner that can help keep your spine properly aligned.
Though spinal fusion is an effective treatment for fractures and deformities in the spine, it will not prevent you from developing back pain in the future. Most of the degenerative conditions in your spine are caused by arthritis and this surgery cannot cure your body of that disease.
Risks and complications
Like most surgeries, there are also a few risks associated with spinal fusion. Before your procedure, you need to discuss each of them with your doctor, so that your doctor can take specific measures to help avoid potential complications. Potential risks and complications of spinal fusion are:
- Infection- Antibiotics are given on a regular basis to the patient before, during and often after surgery so that the risk of infections can be lessened.
- Bleeding- A certain amount of bleeding can be expected, though this is not typically significant. Blood donation is not usually required before the procedure.
- Pain at the graft site- Few patients can experience persistent pain at the bone graft site.
- Recurring symptoms- Some patients can experience a recurrence of their original symptoms. There are usually various reasons for this. If your original symptoms recur, you will need to inform your doctor so that he/she can determine the cause.
- Pseudarthrosis- In this condition, there is not enough bone formation. Patients who smoke are usually more likely to develop this condition. Diabetes and older age can also be factors. Moving too soon before the bone is able to start fusing, might result in a pseudarthrosis as well. If this condition occurs, a second surgery may be required for a solid fusion.
- Nerve damage- Nerves or blood vessels can get injured during these operations, though such complications are rare.
- Blood clots- The formation of blood clots in the legs is another uncommon complication. These can pose significant danger if they break off and travel to the lungs.
It is quite important for you to carefully follow your doctor’s instructions relating to the warning signs of blood clots and infection. These complications can occur during the first few weeks after your surgery.